Alexandre Faddoul, DMD

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

DS044838 Issued in PA

Practice address

3501 Terrace St
Pittsburgh, PA 15213-2523

Phone

(412) 648-8616

NPI assigned

Oct 21, 2024

Last updated

Oct 21, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1729468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1114748357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6788 WILDWOOD TRL",
            "city": "MAYFIELD VILLAGE",
            "state": "OH",
            "postal_code": "441431574",
            "telephone_number": "440-391-1154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 TERRACE ST",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152132523",
            "telephone_number": "412-648-8616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADDOUL",
        "first_name": "ALEXANDRE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-10-21",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "PA",
            "license": "DS044838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trevor David Fachko, MD
• H Michael Fackenthal, DMD
• Michael Fackovec, M.D.
• Emilie Fadale, PA
• Darya Fadavi, MD
• Brett Michael Fadgen, CRNA
• Ali Fadhil, M.D.
• Morgan Faeder, MD, PHD
• Jeanine Fafata
• Maureen Fagan

• Prosthodontics in Pittsburgh, PA
• Providers in Pittsburgh, PA by specialty
• Prosthodontics in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.